Medicare

About Medicare

The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.

MedPAC to Develop Rural Hospital and Clinician Payment Workplan

What’s happening: The Medicare Payment Advisory Commission (MedPAC) is developing a rural hospital and clinician payment policy workplan for 2024–25.  

What else to know: The March MedPAC meeting included discussion to inform a future recommendation to Congress related to rural hospitals.  

CMS Announces New Primary Care Payment Model

What’s happening: The Centers for Medicare & Medicaid Services (CMS) announced the Accountable Care Organization (ACO) Primary Care (PC) Flex Model, a new voluntary payment model that will test how prospective payments and increased funding for primary care in ACOs impact health outcomes, quality, and costs of care.  

What else to know: CMS will launch the model on Jan. 1, 2025. 

CHA Summary: Proposed Changes for Oversight of Accrediting Organizations

What’s happening: CHA is sharing its summary of the Centers for Medicare & Medicaid Services’ (CMS) proposed rule intended to strengthen oversight of accrediting organizations (AOs) such as The Joint Commission and Det Norske Veritas.  

What else to know: While the proposed policies are applicable to AOs, several proposed changes will affect hospitals and health systems that rely on AO accreditation.  

House Passes First Package to Fund Federal Government, Includes Health Provisions

What’s happening: The U.S. House passed the Consolidated Appropriations Act of 2024, which will fund a portion of the federal government through the end of the fiscal year. The package includes a group of CHA-supported health care provisions important to hospitals.  

What else to know: Congress has until March 22 to pass a second package to fund the rest of the federal government, including the Department of Health and Human Services.  

CHA Encourages Members to Participate in the Vitality Index Payer Scorecard

What’s happening: CHA is endorsing member participation in the Vitality Index Payer Scorecard, which will provide critical information to support CHA’s advocacy to hold insurers accountable for timely and accurate reimbursement.  

What else to know: The CHA Board of Trustees has endorsed this tool, which will automatically draw de-identified claims and remittance information from hospitals without requiring additional reporting or surveys.